Commissioners approve 2024 budget, increase ambulance funding

Part time paramedic to join service staff, discuss volunteer shortage

Day County Commissioners held a long discussion about the Day County Ambulance Service and the 2024 budget Sept. 19, ultimately adopting a version of the budget with a tax levy increase but an overall budget decrease.

Day County Ambulance Service Director Chad Madsen submitted multiple budgets reflecting different options for county leaders to consider. Commissioners approved hiring a part-time paramedic to work every other weekend so Madsen can have some time off. They denied hiring additional paramedics which would have increased the number of transfers the service could accommodate.

“We have obviously gone over the call volume of 2023 and we are working everyone hard with the staff shortages we are facing,” Madsen said. “The state (of South Dakota) is having a group meeting about how to address the EMT shortage and supporting ambulance services which are struggling financially.”

Madsen has said in previous meetings ambulance services are unable to survive financially on 911 calls alone and need transfers for the revenue they bring in. Since the service started most of the transfers have been from Sanford Webster Medical Center. They have completed 13 transfers from the Aberdeen area to Sioux Falls since the service started in December 2022. Without the money from transfers it would mean the ambulance service would run in the red. Currently, the service is breaking even between expenses and revenue, according to Madsen.

“My concern is if we do not get more people on board then there is a possibility we could lose some of the volunteers over the next year if we keep working them like we have been,” Madsen said.

He highlighted some of the issues current EMTs are facing. Madsen said there is a lack of volunteers who are willing to work the shifts after 4 p.m. and he is often limited to only one EMT during that time period. Other times, such as weekends, can be a struggle to find enough EMTs because of people who are traveling or going to events. The service currently has just seven EMTs.

“The day of the volunteer is over,” Madsen said. “I can’t just schedule people and tell them they are working a particular shift. No one wants to work nights because they have to go to work in the morning. I am worried it may come to a point where we are not able to respond to a 911 call if we do not get more EMTs and paramedics on board.”

Madsen noted there have been some instances he has not been able to complete transfers from the Webster hospital as he did not have enough people who were available to make calls.

There are currently three people taking an EMT class and Madsen noted they would be a big help, mostly to provide relief for those who have been taking the majority of the calls.

“I suggest you talk to the kids at Lake (Area) Tech(nical College) about coming up here after school or on the weekends to help,” Commissioner Derek Sinner said. “Make the call and see if they are willing to come up and get some experience.”

Madsen said he would talk to the class and see if there is any interest. He noted one issue would be where they would be staying at since there is no central place for ambulance workers to be while not on a call. He said in a recent EMT class only three of 14 passed the test. He said one Webster Area High School student is currently in an EMT class.

Sinner raised the question of how much difference would hiring one additional paramedic have on the service.

“Hiring one additional guy would honestly give us, and me, some time off,” Madsen said. “It would help with the workload problem. When I accepted the position the whole plan was to slow down in my EMS career. But with the number of calls and the numbers we have I haven’t been able to relax.”

Commissioner Jim Walter said the ambulance service budget should be closer to $620,000 with hiring additional paramedics. Walter said he talked to the head of the Clark County Ambulance Service and described how many calls the Day County service was taking. Walter said the Clark County individual told him more in the budget will be needed.

Sinner noted that additional time is needed to see how things are going before committing additional funds to hire more paramedics. Sinner said the goal should be to focus on serving the people of Day County and is confident the people taking the EMT class would pass their tests and then help with the workload for those at the ambulance service.

“If this plan does not pan out and those taking the EMT class do not pass then we will have to do something,” Commissioner Danny Kjos said. “We can’t let this fail and if push comes to shove we will do whatever it takes to keep the service going.”

Madsen said the South Dakota Legislature is going to have to do something to support ambulance services across the state. He said in North Dakota the state provides financial support to ambulance services to keep them operating.

Commissioners approved hiring Matt Gaikowski as an ambulance driver. Since Jan. 1 the service has responded to 365 calls; 39 calls in August and 38 calls in September.

In a final vote the commissioners approved the ambulance service budget for 2024 at $476,751.

The final 2024 budget for Day County was approved at $10,472,075, a decrease from the 2023 budget of $10,800,225. Out of that, the general fund budget stands at $5,394,164 and the total amount of property taxes to be collected by the county stands at $4,870,487, an increase of $167,246 from the 2023 budget. The 2024 budget was adopted by a 4-1 vote with Walter voting no.

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